[Diagnosis of Nonpalpable Breast Cancer in Premenopausal Women].

Objective: To analyze the possibilities of standard and additional methods for X-ray mammography (MG) in the comprehensive diagnosis of nonpalpable breast masses and preclinical cancers; to identify the important radiological signs of malignancy as predictors for the application of multislice spiral computed tomography/ magnetic resonance imaging (MSCT/MRI-MG), as well as invasive studies in premenopausal women. Material and Methods: The investigation enrolled 423 pre-menopausal patients with nonpalpable breast masses; 129 women were found to have breast cancer. The diagnosis was verified by comprehensive clinical and instrumental examination using standard and additional methods for X-ray mammography, ultra-sonography, MRI, MSCT of the breast and biopsy. Significant radiological signs of malignancy of the lesions were detected and their diagnostic value was identified. Results: The use of additional diagnostic techniques for mammography contributes to the confident visualization of important radiological criteria for malignancy, enhances the informative value of by 5%, and promotes a decline in the number of unjustified biopsies by 11%. Conclusion: Problems in visualizing and categorizing nonpalpable breast masses necessitate additional diagnostic techniques for X-ray mammography. The identification and confident interpretation of important radiological criteria for benign or malignant lesions increase the diagnostic value of X-ray mammography: the sensitivity from 91% to 98%, specificity from 61% to 75%. MSCT-MG and MRI-MG demonstrate even higher efficiency: contrast-enhanced (CE) MSCT­MG (100% sensitivity, 99% specificity) and CE MRI­MG (100% sensitivity, 98% specificity). Sequential radiological and morphological studies improve the quality and efficiency of diagnosis of nonpalpable breast cancer.

[Magnetic resonance imaging in the diagnosis of secondary vaginal tumor involvement].

OBJECTIVE: To estimate the capabilities of magnetic resonance imaging (MRI) in revealing and estimating the extent of secondary vaginal involvement. MATERIAL AND METHODS. Thirty patients with secondary vaginal tumor involvement underwent contrast-enhanced MRI. Examinations were made using a 1.5 T MRI. The protocol encompassed T2- and T1-weighted, diffusion-weighted, and dynamic contrast-enhanced MRIs. To smooth out vaginal wall rigosity, the examination was made using an intracavitary MR-compatible applicator. RESULTS: Vaginal metastatic involvement was detected in 30 patients with sustained malignancies at various sites. The largest group consisted of 16 (53.3%) patients with uterine corpus metastases. Secondary vaginal involvement was observed in 11(36.7%) patients with cervix uteri cancer, in 2 (6.7%) patients with progressive ovarian cancer, and in 1 (3.3%) patients with rectal cancer. With a significant tumor volume giving rise to thickening of the vaginal wall or its impaired slice differentiation, the portion of an inhomogeneously increased MR signal portion during T2-weighted MRI, which intensively accumulated the paramagnetic in an arterial and venous phase of dynamic contrast-enhanced MRI, was detected. There were no T2-weighted images of a hypointense muscular layer and paravaginal fat streaks during an invasive process. In our investigation, vaginal metastatic tumors which were enclosed by the mucous membrane and evident as shallow erosion, as shown by the data of clinical and histological examinations, had no specific MRI signs in any of the pulse patterns, which is likely to be associated with the resolution of this technique. CONCLUSION: The proposed protocol of comprehensive magnetic reso nance imaging makes it possible to clearly localize a tumor process into the vagina and to determine the volume and pattern of involvement in most patients, including whose who have a history of antitumor treatment.

[The Russian X-Radiology Research Center: yesterday, today and tomorrow (90 to us)].

The paper gives historical information on the foundation and establishment of the Russian X-Radiology Research Center, as well as the advances that have been fundamental in the further clinical, scientific, and educational activities of the center. It details information of the recent advances of the center in diagnosis, including radiation, clinical and molecular gene, and combined treatments for cancer patients, including surgery, polychemotherapy, and radiotherapy. The achievements of each subdivisions of the Center are given. The paper shows the latest advances of the Center and its workers in researches, which have been embodied in their dissertations, monographs, and guides. Of great importance is the educational process the Center's workers are successfully doing in, by training specialists of different profile.

[History of the development of radiodiagnosis at the Russian Research Center of Roentgenology and Radiology: on the occasion of the 90th anniversary of its foundation].

The paper describes the history of the Russian Research Center of Roentgenology and Radiology set up 90 years ago, the main advances of the researchers of the Institute in roentgenology and radiodiagnosis in historical perspective--from the last century up to the present day. It gives a brief list of the most important procedures and publications on radiodiagnosis, which have been developed and published by the Institute's researchers.

[Potentialities of MRI in the differential diagnosis of peripheral lung cancer and inflammatory changes].

The paper analyzes the authors' own data of chest magnetic resonance imaging (MRI) in 62 patients with verified peripheral lung cancer and different inflammatory changes (round pneumonic focuses, abscesses, etc.). The MRI signs of peripheral lung cancer are systematized. The additional capacities of contrast enhancement are analyzed. The MRI semiotics of different inflammatory changes has been developed. The differential diagnostic criteria for recognizing peripheral lung cancer and inflammatory changes have been also elaborated.

[Comparative analysis of the X-ray morphology of coronary atherosclerosis and the results of endovascular interventions performed in the subacute period and 6 months after prior myocardial infarction].

The study was undertaken to analyze the morphology of coronary lesion and the angiographic results of interventions made in the subacute period and 6 months after prior myocardial infarction. It included 593 patients with and without prior Q-wave myocardial infarction. The X-ray morphological parameters of the coronary bed were analyzed in the patients who had undergone invasive studies within a month (n = 362) and 6 months (n = 231) after sustained myocardial infarction. In both groups, the successful intervention rate was also estimated during endovascular treatment. The study showed that the number of stenoses with the complicated morphology (type B) was significantly more 6 months after sustained myocardial infarction than that in the subacute period. The number of occluded segments with the characteristics that were unfavorable for endovascular intervention (bridge collaterals, extended occlusions) was also significantly more in the late periods. In the subacute period, the angiographic success rate of endovascular recanalizations of chronic occlusions was 83.4%, which was significantly higher than that (62.6%) 6 months following infarction. The findings have led us to the conclusion that it is necessary to make routine coronary angiography in all postinfarction patients during their hospital stay in order to define the potentialities of early revascularization.

[Differential magnetic resonance diagnosis of central lung cancer and acute pneumonia].

The paper analyzes the authors' own data of chest magnetic resonance imaging (MRI) in 86 patients with verified central lung cancer and acute pneumonia. The MRI signs of lung cancer are systematized in exo-, endo-, and peribronchial forms of growth. The additional capacities of contrast enhancement are analyzed. The MRI semiotics of acute pneumonia has been developed. The differential diagnostic criteria for recognizing central lung cancer and acute pneumonia have been also elaborated.

[Peripheral carcinoma of the lung in magnetic resonance imaging].

This study shows magnetic resonance imaging (MRI) to be a technique in the comprehensive diagnosis of peripheral carcinoma of the lung and in the determination of the extent of a tumor process in the chest. The paper specifies and systematizes the MRI signs of peripheral carcinoma of the lung, the signs of tumor invasion into the pleura, chest, and mediastinal structures. It also analyzes additional capacities of contrast enhancement.

[Central cancer of the lung in MR image].

The paper analyzes the authors' own material based on the data of chest magnetic resonance imaging (MRI) in 48 patients with verified central cancer of the lung. The algorithm of chest MRI optimized by the authors is presented. The MRI signs of lung cancer in exo- and peribronchial forms of cancer are systematized. The MRI semiotics of chest structural damages are given in the extent of a tumor when progressing, and a metastatic lesion. The MRI signs of complications of this disease are specified.

[Ultrasonographic guidance in diagnostic and therapeutic interventions in diseases of the internal organs]. / Ul'trazvukovoi metod kontrolia za diagnosticheskimi i lechebnymi vmeshatel'stvami pri zabolevaniiakh vnutrennikh organov.

A hundred fifty four invasive diagnostic and therapeutical interventions were made in patients with diseases of the abdomen and retroperitoneal space under ultrasonographic guidance. Various biopsies were performed in 139 patients; positive results were achieved in 120 (86.3%) cases. In 15 patients, diagnostic biopsies were combined with therapeutical interventions, such as aspiration of cysts in the liver (n = 3) and kidney (n = 2); drainage of abscesses in the abdomen (n = 5) and liver (n = 5). Fourteen patients with mechanical jaundice caused by extrahepatic bile duct tumors or pancreatic head cancer underwent percutaneous transhepatic cholecystocholangiography followed by external drainage. Percutaneous transhepatic drainage of the gallbladder was made in 1 patient with acute cholecystitis.

[Invasive interventions guided by computerized tomography in the diagnosis and treatment of diseases of the internal organs]. / Invazivnye vmeshatel'stva pod kontrolem rentgenovskoi komp'iuternoi tomografii v diagnostike i lechenii zabolevanii vnutrennikh organov.

Diagnostic punctures under CT guidance were made in 544 patients with diseases of the chest (n = 303), abdomen (n = 149), and retroperitoneal space (n = 92). In 87 patients, diagnostic punctures were combined with therapeutical manipulations and included aspiration and drainage of visceral organ cysts and abscesses. The proposed procedure of diagnostic biopsies under CT guidance could ascertain the morphological nature of a lesion in 90.1% of cases prior to treatment. Therapeutical aspirations and drainage of visceral cysts and abscesses under CT guidance resulted in their complete recovery in 97.8 and 85.7% of cases, respectively. Diagnostic and therapeutical interventions under CT guidance caused complications in 6.9% of cases. At diagnostic biopsy, pneumothorax is the most frequent complication *5.3%), and lung tissue hemorrhage along the puncture needle passage is the less frequent (1.3%). The use of therapeutical interventions developed complications in 1.1% of cases.

[MRI diagnosis of soft tissue tumors]. / MR-tomograficheskaia diagnostika opukholei miagkikh tkanei.

MRI findings of 13 patients with soft tissue tumors (STT) are presented. There are were abnormalities, such as primary STTs of the hip in 5 patients, the back in 1, and the neck in 1, STT relapses of the hip in 2 and those of the back in 1. Two patients had chronic hip STT hematomas and 1 had hip STT metastatic melanoma. The diagnosis was verified in 11 cases (in 10 cases at surgery and 1 at needle biopsy). MRI makes it possible to define the accurate sizes of the tumor, its structure and relationship to its adjacent tissues, which is important in choosing at treatment policy, the type and scope of a surgical interventions.

[Puncture methods of the diagnosis and treatment under the control of US, CT and X-ray video image]. / Punktsionnye metody diagnostiki i lecheniia pod kontrolem UZ, KT i rentgenotelevizionnogo izobrazheniia.

Exploratory and therapeutical punctures were made in 454 patients under the control of ultrasound, CT, and X-ray teleimage. Diagnostic biopsies established the cytological and histological nature of diseases in 67.6% of cases, positive ultrasound-, CT-, and X-ray teleimage-controlled biopsies being 76.3, 64.9, and 71.4%, respectively. Beneficial effects of therapeutical interventions were obtained in 89.5% of patients.

[Diagnostic possibilities of CT-guided lung biopsy]. / Diagnosticheskie vozmozhnosti biopsii legkikh pod kontrolem KT.

The authors analyse the results of computer-aided tomographic biopsies in 81 patients with various pulmonary diseases (63 with tumors, 53 of these with malignant ones, and 18 with nontumors diseases). Positive results were obtained in 86.4% of cases. Biopsies proved to be informative in 44 out of 48 patients with lung cancer, in 8 out of 10 ones with benign tumors, and in 10 out of 12 ones with nonspecific inflammations. The results were not informative in 13.6% of patients. In 4 cases the failure was caused by the absence of cellular material in the puncture biopsy specimen, in 5 it was due to the presence of only pulmonary cells. In two more cases the diagnosis of lung cancer made by computer-aided biopsy was erroneous because of the presence of inflammation elements and amorphous mass in the examined. Complications occurred in 22 (27.2%) patients, pneumothorax in 16 (19.8%) and local pulmonary hemorrhages in 6 (7.4%) of these. Hence, computer-aided biopsy of the lung is an informative diagnostic method, permitting a correct diagnosis in the majority of cases.

[Computerized myelotomography in lesions of the spine and spinal cord]. / Komp'iuternaia mielotomografiia pri porazheniiakh pozvonochnika i spinnogo mozga.

CT myelotomography was carried out in 262 patients with various conditions of the spine and cord. Pathologic changes were detected in 233 (87.6%) of the examinees. The most frequent diseases were tumors and metastases (59 cases), degenerative processes, including primary and recurrent hernias (59 cases), atrophic processes (46 cases). The accuracy of the diagnosis was found to be 98.6%. A false-positive result was obtained in one case with a suspected tumor of the cord. No complications were recorded. Computer-aided myelotomography is an effective method for the diagnosis of involvement of the spine and cord.

[Errors and complications in computed tomography-guided biopsies]. / Oshibki i oslozhneniia pri biopsiiakh pod kontrolem komp'iuternoi tomografii.

The article analyses the results of 104 biopsies which were carried out in 84 patients with different diseases of the organs of thoracic (50) or abdominal (16) cavities, postperitoneal space (32), bones and soft tissues (6). Positive results were obtained in 67 cases, negative--in 26, false-negative--in 11. The specificity was 70.3%, sensitivity--100%, authenticity--64.4%. The authors make a conclusion that the results and authenticity of biopsies depend on such factors as the proper organ to be punctured, character and structure of the affection, its location, volume and spreading, as well as the type of needles to be used.

[Invasive interventions with computerized tomography guidance]. / Invazivnye vmeshatelstva pod kontrolem kompíuternoi tomografii.

Invasive interventions (diagnostic and therapeutic) were conducted on 125 patients. Fifty-six has diseases of the lungs, 16 of the mediastinum, 4 of the pleura, 17 of the liver, 2 of the pancreas, one of the spleen, 15 of the kidneys, 7 of the retroperineal space, two of the soft tissues, and 5 patients had diseases of the skeletal bones. Biopsy was combined with aspiration of the renal cyst content in 7 cases. The diagnostic value of biopsy under control of CT was 86% (106 cases); negative and pseudonegative results were recorded in 18 (14%) patients. The efficacy of biopsy is determined by such factors as the size of the lesion and the depth of its localization in the involved organ, the character of the pathological process and the region of its localization, the site from which the material is collected, and the needles used. Among 7 patients with therapeutic interventions, 5 had good and 2 had satisfactory immediate results. Complications were revealed in 4 (3.3%) patients, pneumothorax was encountered most frequently.

[The potentials of computed tomography in the treatment of cysts and inflammatory diseases of the internal organs]. / Vozmozhnosti komp'iuternoi tomografii v lechenii kist i vospalitel'nykh zabolevanii vnutrennikh organov.

Computed tomography (CT) is used more and more often recently in the treatment of some surgical diseases of the internal organs. The subject of discussion in this work are the results of treatment of cysts and pyoinflammatory diseases of the internal organs. The work was conducted on CT IV generation "QUAD 1" of the CMS firm (England). Needles measuring 14-18d in diameter (Charrière scale) were used for aspiration. A total of 23 therapeutic interventions were performed in 19 patients with exudative pleurisy (1 patient), pleuritis (4), pulmonary abscesses (1), abscesses of the liver (1), abscesses of the subhepatic and subdiaphragmatic spaces (2), cysts of the liver (1) and kidneys (1 patient). Among the interventions 21 were aspirations and 2 drainage of the abscess. A mechanical syringe is used lately for more effective evacuation of the contents. The removed contents, ranging in volume from 10.0 to 600.0 ml, was subjected to cytological, biochemical, and bacteriological analysis. A single puncture is sufficient, as a rule, for aspiration of the cyst contents, one-stage aspiration from cysts of both kidneys may be conducted (as was the case in two of our patients). 96% alcohol was used as the sclerosing agent. In cases of small abscesses aspiration may be repeated for removal of the contents, irrigation of the cavity, and administration of antibiotics. In abscesses measuring more than 10 cm drainage is advisable. Control CT examination is conducted once a week. The condition of the cavity is appraised by combining CT with its contrast study. The immediate results were good and satisfactory in 17 (94.7%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)